Is the multiracial congregation an answer to the problem of race? Comparative perspectives from South Africa and the USAF

This paper uses a comparative perspective to analyze how multiracial congregations may contribute to racial reconciliation in South Africa. Drawing on the large-scale study of multiracial congregations in the USA by Emerson et al., it examines how they help transform antagonistic identities and make religious contributions to wider reconciliation processes. It compares the American research to an ethnographic study of a congregation in Cape Town, identifying cross-national patterns and South African distinctives, such as discourses about restitution, AIDS, inequality and women. The extent that multiracial congregations can contribute to reconciliation in South Africa is linked to the content of their worship and discourses, but especially to their ability to dismantle racially aligned power structures. © Koninklijke Brill NV, 2008.

Beyond Pietism and Prosperity: Religious Resources for Reconstruction and Reconciliation in Zimbabwe

It is often assumed that charismatic Christianity in Africa promotes either a pietist withdrawal from social and political concerns, or a preoccupation with gaining individual health and wealth (the prosperity gospel). This research presents an alternative vision of the role of charismatic Christianity in Zimbabwe. Drawing on an ethnographic case study of a charismatic congregation, it analyzes how these Christians are drawing links between spirituality and social action. This congregation is developing an egalitarian conception of power, promoting service to the poor, and using biblical discourses to support their actions. This can be understood as part of a wider process in which Zimbabwean Christians are using religious resources to develop a vision for reconstruction and reconciliation. This article points to further areas in which the churches could use their public position to raise sensitive issues, including how to deal with the past and heal relationships between previously antagonistic groups.

Inside the tent: Community and government in refugee camps

Refugee camps are increasingly managed through a liberal rationality of government similar to that of many industrialized societies, with security mechanisms being used to optimize the life of particular refugee populations. This governmentality has encompassed programmes introduced by the United Nations High Commissioner for Refugees (UNHCR) and various non-governmental organizations (NGOs) to build and empower communities through the spatial technology of the camp. The present article argues that such attempts to ‘govern through community’ have been too easily dismissed or ignored. It therefore examines how such programmes work to produce, manage and conduct refugees through the use of a highly instrumentalized understanding of community in the spatial and statistical management of displaced people in camps. However, community is always both more and less than what is claimed of it, and therefore undermines attempts to use it as a governing tactic. By shifting to a more ontological understanding of community as unavoidable coexistence, inspired by Jean-Luc Nancy, we can see how the scripting of and government through community in camps is continually exceeded, redirected and resisted. Ethnographies of specific camps in Africa and the Middle East enable us both to see how the necessary sociality of being resists its own instrumentalization and to view the camp as a spatial security technology. Such resistance does not necessarily lead to greater security, but it redirects our attention to how community is used to conduct the behaviour of refugees, while also producing counter-conducts that offer greater agency, meaning and mobility to those displaced in camps.

John Thompson: Seeing through China

In 1848, Karl Marx predicted that a flow of cheap commodities would be the heavy artillery which would batter down all Chinese walls and open up the country to the west (Marx, 1978, p. 477). The Scottish photographer John Thomson (1837-1921) was both chronicler of and participant in the early moments of this process. Thomson was a commercial photographer who first arrived in the Far East in 1862. He earned the moniker of 'China' in a decade-long stay during which he photographed what he considered to be the key aspects of its culture and landscape. In this body of work, Illustrations of China and its People (first published in 1874) is perhaps the most comprehensive. It explores, through two hundred photographs and accompanying texts, a series of phenomena from the macro-scale of landscape, infrastructure and industry to the smaller scales of streetscapes, domestic spaces, individual portraits, and other details of everyday life. Despite his own description of the volumes as encyclopedic, Illustrations is geographically quite limited. Thomson's explorations into the hinterland proceed up the country’s principal rivers from those coastal ports which had already been wrested into western hands during the Opium Wars (of the 1840s) and subsequently opened up to trade. This is perhaps one of the reasons why Illustrations has been described as an explicitly colonial text, a guide-book for the prospective settler whose content offered the strategic knowledge of land, culture and natural resources necessary if the territorial advantages of the coastal periphery were to extended to the interior (Jeffrey, 1981, p. 64). It can also be argued, however, that Thomson’s volume offered justification for a potential colonial presence. Faced with a civilization whose history was as sophisticated as the west, it depicts a culture that is static and moribund, its addiction to traditional values an impediment to progress. While this is perhaps most explicit in the texts of Illustrations of China, it can also be seen in the images whose uniform chemical rendering also serves to make an essentially diverse culture seem homogenous. Yet it is these images that distinguish Illustrations from previous attempts to collate China’s culture and landscape. Here, the mechanical precision of his camera captures a reality that often subverts the colonial narrative, confounding stereotypes as Thomson’s mass-produced images allow another China to emerge.

Seven key actions to eradicate rheumatic heart disease in Africa: the Addis Ababa communiqué

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain major causes of heart failure, stroke and death among African women and children, despite being preventable and imminently treatable. From 21 to 22 February 2015, the Social Cluster of the Africa Union Commission (AUC) hosted a consultation with RHD experts convened by the Pan-African Society of Cardiology (PASCAR) in Addis Ababa, Ethiopia, to develop a 'roadmap' of key actions that need to be taken by governments to eliminate ARF and eradicate RHD in Africa. Seven priority areas for action were adopted: (1) create prospective disease registers at sentinel sites in affected countries to measure disease burden and track progress towards the reduction of mortality by 25% by the year 2025, (2) ensure an adequate supply of high-quality benzathine penicillin for the primary and secondary prevention of ARF/RHD, (3) improve access to reproductive health services for women with RHD and other non-communicable diseases (NCD), (4) decentralise technical expertise and technology for diagnosing and managing ARF and RHD (including ultrasound of the heart), (5) establish national and regional centres of excellence for essential cardiac surgery for the treatment of affected patients and training of cardiovascular practitioners of the future, (6) initiate national multi-sectoral RHD programmes within NCD control programmes of affected countries, and (7) foster international partnerships with multinational organisations for resource mobilisation, monitoring and evaluation of the programme to end RHD in Africa. This Addis Ababa communiqué has since been endorsed by African Union heads of state, and plans are underway to implement the roadmap in order to end ARF and RHD in Africa in our lifetime.

Sexual Abuse in Malawi: Patterns of Disclosure

Potential human immunodeficiency virus transmission makes prompt disclosure of child sexual abuse in Africa critical. The pattern of disclosure of 133 children presenting to the largest hospital in Malawi were analyzed. Eighty percent presented early enough for effective use of HIV postexposure prophylaxis. Seventy-five percent of children made a disclosure of child sexual abuse; 29% spontaneously and 47% after prompting. Disclosures were most commonly made to a parent, and age did not affect the pattern of disclosure. The number of children reporting child sexual abuse is increasing, possibly because of increasing awareness, availability of services, and fear of HIV. Although prompt disclosure rates were relatively high, facilitating easier disclosure of child sexual abuse by a free telephone help-line and better training of teachers may be helpful. 

Mathematical Modeling to Assess the Drivers of the Recent Emergence of Typhoid Fever in Blantyre, Malawi

BACKGROUND: Multiyear epidemics of Salmonella enterica serovar Typhi have been reported from countries across eastern and southern Africa in recent years. In Blantyre, Malawi, a dramatic increase in typhoid fever cases has recently occurred, and may be linked to the emergence of the H58 haplotype. Strains belonging to the H58 haplotype often exhibit multidrug resistance and may have a fitness advantage relative to other Salmonella Typhi strains.

METHODS: To explore hypotheses for the increased number of typhoid fever cases in Blantyre, we fit a mathematical model to culture-confirmed cases of Salmonella enterica infections at Queen Elizabeth Central Hospital, Blantyre. We explored 4 hypotheses: (1) an increase in the basic reproductive number (R0) in response to increasing population density; (2) a decrease in the incidence of cross-immunizing infection with Salmonella Enteritidis; (3) an increase in the duration of infectiousness due to failure to respond to first-line antibiotics; and (4) an increase in the transmission rate following the emergence of the H58 haplotype.

RESULTS: Increasing population density or decreasing cross-immunity could not fully explain the observed pattern of typhoid emergence in Blantyre, whereas models allowing for an increase in the duration of infectiousness and/or the transmission rate of typhoid following the emergence of the H58 haplotype provided a good fit to the data.

CONCLUSIONS: Our results suggest that an increase in the transmissibility of typhoid due to the emergence of drug resistance associated with the H58 haplotype may help to explain recent outbreaks of typhoid in Malawi and similar settings in Africa.

L'Asse Tripartito Italia-Germania- Giappone e la Cina

Germany, Italy and Japan were engaged in China from the turn of the 20th century to WWII. However, they formed an anti-Chinese alliance only at the final stage of their presence there, when Japan assumed an undisputed role of leader in the region. Despite its alliance with the Axis powers, Japan never implemented racial laws against the Jews in China. All of them took part in the Boxer Upraising suppression and received as a consequence extraterritorial rights and concessions. Moreover, Japan won the war against China in 1895 and transformed itself from a tributary country of China into an imperialistic power. It took possession of Taiwan and in the 1930s established a puppet government in Manchuria.Germany followed different route obtaining as indemnity for the murders of two missionaries the control of the Shandong province, which was later expanded thanks to the anti-Boxer coalition's victory. However, Germany lost all possessions when China entered WWI. The issue of Shandong was finally resolved at the Conference for Disarmament hold in Washington in 1921-2. Japan failed to gain ex-Germany territories. Finally, Italy arrived in the Far East at the turn of the century but was not very interested in the oriental colonialism to the same extent it was interested in Africa. Tianjin was its only concession in China, and it took almost a decade before a subvention to arrive from the Italian government for its development.In the 1920s and 1930s Germany and Italy engaged in successful diplomatic, commercial and military relationships with China. In fact, both were considered China's partners thanks to their experts at the service of the Chinese government. On the other hand, Japan position was opposite to them, because of its plans of aggression towards China which was to be transformed into “the natural extension” of the mainland. In 1935 Italy declared war on Ethiopia and abandoned the seat at the League of Nations. China interpreted the Italian aggression as the endorsement of Japan's politics towards China in Manchuria, and the relations between the two countries were broken off. After that Italy supported Wang Jingwei's puppet government during the Japanese occupation of China. Germany followed the same path in 1937, when it was evident that the Japanese were playing the leading role in the region, and decided to ally with Wang Jingwei too. Both Italy and Germany decided also to recognise the Manzhuguo and established diplomatic relations, definitively turning their backs on the old Chinese ally.The Rome-Berlin-Tokyo Axis sealed the alliance among the three countries, and it confirmed Japan as the leading power in the region. Nevertheless Japan did not apply the racial law against the Jews in China.

Clinical Outcomes in 3343 Children and Adults with Rheumatic Heart Disease from 14 Low and Middle Income Countries: 2-Year Follow-up of the Global Rheumatic Heart Disease Registry (the REMEDY study)

BACKGROUND: -There are few contemporary data on the mortality and morbidity associated with rheumatic heart disease (RHD) or information on their predictors. We report the two year follow-up of individuals with RHD from 14 low and middle income countries in Africa and Asia.

METHODS: -Between January 2010 and November 2012, we enrolled 3343 patients from 25 centers in 14 countries and followed them for two years to assess mortality, congestive heart failure (CHF), stroke or transient ischemic attack (TIA), recurrent acute rheumatic fever (ARF), and infective endocarditis (IE).

RESULTS: -Vital status at 24 months was known for 2960 (88.5%) patients. Two thirds were female. Although patients were young (median age 28 years, interquartile range 18 to 40), the two year case fatality rate was high (500 deaths, 16.9%). Mortality rate was 116.3/1000 patient-years in the first year and 65.4/1000 patient-years in the second year. Median age at death was 28.7 years. Independent predictors of death were severe valve disease (hazard ratio (HR) 2.36, 95% confidence interval (CI) 1.80-3.11), CHF (HR 2.16, 95% CI 1.70-2.72), New York Heart Association functional class III/IV (HR 1.67, 95% CI 1.32-2.10), atrial fibrillation (AF) (HR 1.40, 95% CI 1.10-1.78) and older age (HR 1.02, 95% CI 1.01-1.02 per year increase) at enrolment. Post-primary education (HR 0.67, 95% CI 0.54-0.85) and female sex (HR 0.65, 95%CI 0.52-0.80) were associated with lower risk of death. 204 (6.9%) had new CHF (incidence, 38.42/1000 patient-years), 46 (1.6%) had a stroke or TIA (8.45/1000 patient-years), 19 (0.6%) had ARF (3.49/1000 patient-years), and 20 (0.7%) had IE (3.65/1000 patient-years). Previous stroke and older age were independent predictors of stroke/TIA or systemic embolism. Patients from low and lower-middle income countries had significantly higher age- and sex-adjusted mortality compared to patients from upper-middle income countries. Valve surgery was significantly more common in upper-middle income than in lower-middle- or low-income countries.

CONCLUSIONS: -Patients with clinical RHD have high mortality and morbidity despite being young; those from low and lower-middle income countries had a poorer prognosis associated with advanced disease and low education. Programs focused on early detection and treatment of clinical RHD are required to improve outcomes.